H1N1 vaccine offer underwhelms Marylanders

Maryland Gov. Martin O'Malley on Tuesday threw open swine flu shots to all who want them -- and Joann Butler shrugged.

"They said it's on the decline. It's not going to be the pandemic they thought it was going to be," said Butler, 45, a healthy Montgomery County program manager, who said she's going to pass. "I wasn't a priority. . . . Is it a compelling need?"

But Laytonsville lawyer Damon Bernstein, 55, is open to it. Maryland officials said the H1N1 vaccine will be available at pharmacies and retailers, including CVS, Giant, Safeway, Target and others, with sales starting next week. "If it's convenient, I'd get a shot. I haven't thought about it because I thought it was restricted," Bernstein said. "It's probably the right thing to do."

Maryland health officials have been limiting vaccinations to priority groups identified by the Centers for Disease Control and Prevention. But that system is being undone in a small but growing number of states, including Tennessee and Oklahoma. "Over the next couple weeks, we'll probably see a dozen states open up to the general population," said Paul Jarris, executive director of the Association of State and Territorial Health Officials, who said H1N1 has peaked in some parts of the country.

Maryland health officials said that attendance at clinics had slowed in parts of the state; that pediatricians, obstetricians and other specialty doctors had been supplied with the bulk of the vaccine they requested; and that the state is receiving more supplies from the CDC. On Monday, the state was allocated 168,000 doses, the state's highest tally yet.

Virginia plans to distribute to pharmacies next week as well, although in a more limited fashion, officials said.

The CDC says it is still targeting five priority groups that are more likely to face serious illness: pregnant women, people ages 6 months to 24 years, caregivers of those younger than 6 months, health and emergency workers, and people ages 25 to 64 who have underlying conditions.

District health officials said they are sticking with the designated groups for now.

"We are wanting providers to continue to focus on the priority groups," said CDC spokesman Tom Skinner. But, he said, federal guidelines allow state officials to reach out to the wider population if they think they've met demand. "The bottom line is, the states and local health departments are in the best position to make that call," Skinner said.

Fewer than half of the estimated 2.9 million Marylanders in the CDC priority groups have been vaccinated, health officials said.

But O'Malley (D) and other officials said getting vaccine out quickly now that supplies are rising is the best way to protect everyone. It will be easier for those in priority groups to get the vaccine at pharmacies, too, they say.

"The vaccine's finally gone from a dribble into a flow," said Virginia Health Commissioner Karen Remley.

Officials told doctors this week that they should not turn away patients, even if they are not in a priority group. Some pharmacies might soon have the nasal spray version, she said. "Next week, in some version, we will be in those pharmacies and big-box stores," she said.